AB0656 Carotid Intima-media thickness as potential marker of cardiovascular risk in systemic sclerosis: a cross-sectional study.
Authors: F. S. Iaquinta, S. Di Napoli, R. Grosso, S. Naty, V. Cassano, D. Crescibene, G. Armentaro, A. Sciacqua, R. D. Grembiale
Journal: Annals of the Rheumatic Diseases (2022)

Background In several rheumatic diseases, persistent inflammatory state has been related to an accelerated atherosclerosis. Although the risk of cardiovascular (CV) events and atherosclerosis is increased in patients with Systemic Sclerosis (SSc), the exact underlying process has not been well defined. Indeed, inflammation is not a remarkable feature of systemic sclerosis pathogenesis as in other inflammatory rheumatic diseases. Objectives The aim of this study was to evaluate the carotid intima-media thickness (c-IMT) as potential marker of cardiovascular damage in SSc patients. Methods Between April and July 2021, 14 consecutive patients with SSc and 14 control subjects were enrolled in the study. Participants were aged &gt; 18 and were able to provide written informed consent. Demographic, anthropometric and cardiovascular risk factors (smoking, arterial hypertension, diabetes and family history of CV events) were collected for each subject. Moreover, an evaluation of the sero-haematological characteristics was also performed. The c-IMT was assessed by the same qualified physician through a B-mode ultrasound examination. C-IMT values ≥ 0.9 mm were considered pathological. Results Demographic and clinical characteristics are shown in Table 1. Traditional CV risk factors were similar between groups, although BMI was significantly lower in SSc patients than controls (24±6 vs 26±2; p =0.019). Patients’ median disease duration was 11 [5.0-16] years. Three patients had limited and 11 patients had diffuse disease according to LeRoy classification. Anti-nuclear antibodies were detected in all SSc subjects. Three patients expressed anti-centromere antibodies (ACA), other 3 are anti-Scl70 antibodies positive, only one patient showed anti-RNA polymerase III antibodies and 7 patients did not presented specific SSc autoantibodies. SSc patients had slightly increased c-IMT compared with controls, however the difference did not reach statistical significance (median c-IMT 0.84 [0.72-0.91] vs median c-IMT 0.68 [0.63-0.82], p =0.164). Table 1. Controls (n=14) SSc patients (n=14) p Demographic and Anthropometric Age (years) 60±4 61±13 0.836 Gender, female (%) 14 (100) 14 (100) - Smoking habit, yes (%) 5 (36) 5 (36) 1 AH, yes (%) 7 (50) 8 (57) 0.705 T2DM, yes (%) 5 (36) 4 (29) 0.686 Dyslipidemia, yes (%) 6 (43) 4 (29) 0.430 CVD familiarity, yes (%) 6 (43) 4 (29) 0.430 Total Cholesterol (mg/dl) 189 [167-218] 170 [128-197] 0.094 LDL (mg/dl) 117 [96-139] 100 [80-115] 0.125 HDL (mg/dl) 61 [50-77] 56 [45-63] 0.329 Triglycerides (mg/dl) 107 [62-133] 107 [69-151] 0.667 Treatment Iloprost 0 (0) 14 (100) 1.21x10 -7 ERA, yes (%) 0 (0) 9 (64) 2.71x10 -4 HMG-CoA reductase inhibitors, yes (%) 6 (43) 4 (29) 0.430 Continuous data are presented as mean ± standard deviation or as median and interquartile range. Binomial data are shown as frequencies and percentages. The overall p-value was calculated by the Mann–Whitney non-parametric test for independent samples and by Chi-squared test as appropriate. Conclusion In our study patients with SSc had a non-significative increased c-IMT compared with controls ( p =0.164), however different results have been reported in previous studies. Although it is not clear whether c-IMT may be considered a marker of cardiovascular damage in SSc, further studies are needed to clarify its role. References [1]Nussinovitch U, Shoenfeld Y. Atherosclerosis and macrovascular involvement in systemic sclerosis: myth or reality. Autoimmun Rev. 2011 Mar;10(5):259-66. doi: 10.1016/j.autrev.2010.09.014. Epub 2010 Sep 21. PMID: 20863903. Disclosure of Interests None declared